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Prescriber Criteria Form Tigris 2024 PA Fax 1305A v2 010124.docx Tigris (osimertinib) Coverage Determination This fax machine is located in a secure location as required by HIPAA regulations. Complete/review

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How to fill out tagrisso osimertinib - prior

01

Obtain the prescription from a healthcare provider.

02

Review the medication guide provided with Tagrisso.

03

Take the prescribed dosage of Tagrisso at the same time every day.

04

Swallow the tablet whole with water, with or without food.

05

Follow any additional instructions given by your healthcare provider.

Who needs tagrisso osimertinib - prior?

01

Patients diagnosed with non-small cell lung cancer (NSCLC) who have specific mutations in the EGFR gene may need Tagrisso (Osimertinib) as a prior treatment option.

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What is tagrisso osimertinib - prior?

Tagrisso (osimertinib) is a medication used for the treatment of non-small cell lung cancer (NSCLC) that has specific mutations in the EGFR gene.

Who is required to file tagrisso osimertinib - prior?

Healthcare providers or pharmacies that dispense Tagrisso (osimertinib) may be required to file prior authorization requests to ensure that patients meet the necessary criteria for obtaining the medication.

How to fill out tagrisso osimertinib - prior?

To fill out a prior authorization for Tagrisso, providers need to complete the required forms specific to the patient's insurance provider, including patient information, diagnosis details, and supporting medical documentation.

What is the purpose of tagrisso osimertinib - prior?

The purpose of filing a prior authorization for Tagrisso is to obtain approval from the insurance company to ensure that the treatment is medically necessary and covered under the patient's health plan.

What information must be reported on tagrisso osimertinib - prior?

The information required typically includes patient demographics, medical history, details of the lung cancer diagnosis, previous treatments, and any relevant diagnostic test results that support the need for Tagrisso.

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